The present disclosure generally relates to endostapler delivery systems and methods employed in the treatment of vascular disease. More particularly, it relates to endovascular stapling devices and methods for use in the fixation of grafts to the walls of vessels.
In modern medical practice, it is sometimes desirable to pass a staple or clip into or through the wall of a luminal anatomical structure (e.g., a blood vessel or other anatomical conduit) for the purpose of attaching an article (e.g., an endoluminal, extraluminal or transluminal graft) or other apparatus to the wall of the anatomical structure.
Examples of medical procedures wherein it is desirable to anchor or attach a graft or other apparatus to the wall of a blood vessel or other luminal anatomical conduit includes certain endovascular grafting procedures whereby a tubular graft is placed within the lumen of an aneurysmic blood vessel to create a neo-lumen or artificial flow conduit through an aneurism, thereby eliminating the exertion of blood pressure on the aneurism and allowing the aneurysmic space to subsequently become filled in with granulation tissue. These endovascular grafting procedures have heretofore been used to treat aneurisms of the abdominal aorta, as well as aneurisms of the descending thoracic aorta. The endovascular grafts typically incorporate or are combined with one or more radially expandable stents which are radially expanded in situ to anchor the tubular graft to the wall of the blood vessel at sites upstream and downstream of the aneurism. Thus, the grafts are typically held in place by friction via the self-expanding or balloon expandable stents. The grafts may also be affixed to vessels with hooks or barbs.
However, in the event that these stent(s) fail to establish sound frictional engagement with the blood vessel wall, the graft may undergo undesirable migration or slippage, or blood may leak into the aneurysmic sac (sometimes referred to as an “endoleak”). Thus, in view of the above-mentioned undesirable complications associated with the use of radially expandable stents to frictionally anchor a graft or other apparatus to the wall of a blood vessel (or other luminal anatomical structure), there exists a need for the development of new endoluminal attachment devices which may be used to deliver one or more staples in attaching the opposite end of an endoluminal tube graft (or other article) to the surrounding wall of the blood vessel or tubular anatomical conduit, thereby ensuring sound and permanent placement of the graft or other article. In this regard, while surgical stapling devices are generally known, the anatomical constraints presented by endovascular application (e.g., catheter-based) present numerous staple/clip deployment difficulties.